肌萎缩侧索硬化症吞咽困难的评估与管理：言语语言病理学家临床实践调查
Evaluation and Management of Dysphagia in Amyotrophic Lateral Sclerosis: A Survey of Speech-Language Pathologists' Clinical Practice.
作者信息
Epps Denise, Kwan Justin Y, Russell James W, Thomas Talisa, Diaz-Abad Montserrat
机构信息
Department of Rehabilitation Services, University of Maryland Medical Center Midtown Campus, Baltimore, MD.
Department of Neurology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
出版信息
J Clin Neuromuscul Dis. 2020 Mar;21(3):135-143. doi: 10.1097/CND.0000000000000281.
OBJECTIVES
The aim of this study was to determine the evaluation and management of dysphagia in amyotrophic lateral sclerosis (ALS) patients by speech-language pathologists (SLPs).
METHODS
A 15-question web-based survey sent to SLPs in general clinical practice.
RESULTS
Forty-nine SLPs responded. Although only 8 (17.0%) of the SLPs worked in ALS clinics, 46 (93.9%) had worked with ALS patients. A variety of dysphagia evaluation protocols were used by 43 (97.7%) SLPs. Most SLPs, 40 (88.9%), recommended instrumental assessments, but timing and indication varied greatly: 19 (42.2%) SLPs recommended this at baseline even without bulbar symptoms, whereas others recommended this based on symptoms and/or clinical assessments.
CONCLUSIONS
There is currently no uniform approach as to the indication, timing, and specific methods to use in the evaluation of dysphagia in ALS patients among SLPs. There is need for further research to assist in the development of definitive guideline recommendations for this population.
目的
本研究旨在确定言语语言病理学家（SLP）对肌萎缩侧索硬化症（ALS）患者吞咽困难的评估和管理方法。
方法
向从事一般临床实践的SLP发送了一份包含15个问题的网络调查问卷。
结果
49名SLP做出了回应。虽然只有8名（17.0%）SLP在ALS诊所工作，但46名（93.9%）曾接触过ALS患者。43名（97.7%）SLP使用了多种吞咽困难评估方案。大多数SLP，即40名（88.9%），推荐进行仪器评估，但时机和指征差异很大：19名（42.2%）SLP即使在没有延髓症状的基线时也推荐进行此项评估，而其他SLP则根据症状和/或临床评估来推荐。
结论
目前，SLP在评估ALS患者吞咽困难时，对于评估的指征、时机和具体方法尚无统一的方法。需要进一步研究以协助制定针对这一人群的明确指南建议。
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